Encrusted Cystitis and Pyelitis

Giannakopoulos, Stilianos; Alivizatos, Gerasimos; Deliveliotis, Ch.; Skolarikos, Andreas; Kastriotis, J.; Sofras, F.

doi:10.1159/000052483

Cited by 20 publications

(15 citation statements)

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“…By chemotaxonomic studies and 16S rDNA sequence comparison, C. urealyticum is most closely related to the lipophilic species magnesium phosphate (struvite) stones (Soriano et al, 1985(Soriano et al, , 1986, indicating that urease may play a prominent role in pathogenicity of this species. Clinical isolates of C. urealyticum were documented to cause alkaline-encrusted cystitis (Soriano et al, 1985), encrusted pyelitis following renal transplantation (Aguado et al, 1993), and other urinary tract infections Funke et al, 1997;Giannakopoulos et al, 2001;van Hooland et al, 2005). Encrusted cystitis may require endoscopic resectioning of encrustations and antibiotic therapy for permanent cure (Funke et al, 1997;van Hooland et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

The lifestyle of Corynebacterium urealyticum derived from its complete genome sequence established by pyrosequencing

Tauch

Trost

Tilker

et al. 2008

Journal of Biotechnology

115

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Section: Introductionmentioning

confidence: 99%

The lifestyle of Corynebacterium urealyticum derived from its complete genome sequence established by pyrosequencing

Tauch

Trost

Tilker

et al. 2008

Journal of Biotechnology

115

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“…This occurs when urease-producing microorganisms cause a rise in the pH of the urine which, in turn, precipitates the deposition of the inorganic salts. The patient presented with symptoms of cystitis (11). Symptoms of UTI in the presence of urine with alkaline pH and struvite crystals are strongly suggestive of infection with C. urealyticum (12).…”

Section: Resultsmentioning

confidence: 99%

Encrusted Cystitis in an Immunocompromised Patient: Possible Coinfection by Corynebacterium Urealyticum and E. Coli

Penta

Fioriti

Chinazzi

et al. 2006

Int J Immunopathol Pharmacol

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Encrusted cystitis is a severe chronic inflammatory disease of the bladder characterized by excessively alkaline urine and calcifications within the bladder wall. A case of a 60 year-old man affected by systemic lupus erythematosus (SLE), which developed encrusted cystitis due to Corynebacterium urealyticum with E. coli coinfection, shows that the treatment of encrusted cystitis with a endoscopic debulking of the encrusted stones and an antimicrobial therapy specific for C. urealyticum often is not sufficient for the complete resolution of symptoms.C. urealyticum is a Gram-positive, slow-growing, multiresistant, urease-positive microorganism with diphtheroid morphology. Since 1985 it has been known as a cause of alkaline encrusted cystitis and other urinary tract infections (1), occurring mainly in patients subjected to urological manipulation. Alkaline encrusted cystitis is a condition characterized by the deposition of inorganic salts on a damaged urothelium. The patient presents symptoms of cystitis (2). Moreover C. urealyticum has been involved in endocarditis, pneumonia, peritonitis, osteomyelitis and soft-tissue infections (3). We report a case of encrusted cystitis due to Corynebacterium urealyticum in a patient with SLE. MATERIALS AND METHODSA 60 year-old man, affected by SLE and in treatment with steroid therapy, presents with persistent symptoms of urinary tract infection including dysuria, pollakiuria, and intermittent hematuria with urinary gravel. He had undergone cystoscopy, which showed stone deposits in the bladder wall. Analysis of the urinary stone deposits on the bladder mucosa revealed the presence of ammonium magnesium phosphate (struvite) and calcium hydroxy phosphate (apatite).The urine sample was plated onto modified MacConkey agar (Oxoid) and CLED (cystine-Iactoseelectrolyte-deficient) agar and incubated at 37°C for 48 h. The identification and the antibiotic sensitivity testing for common pathogen germs were performed with the Phoenyx identification system (Becton Dickinson, USA). The urine and pus culture for Corynebacterium spp. on 7% sheep blood agar (Oxoid, England) was performed with incubation at 37°C in air for 24 h. The microbiological criteria for identification of C. urealyticum were the presence of gram-positive bacteria with diphtheroid morphology catalase-positive and strongly urease-positive. For identification the APICoryne identification strip (API Laboratory' Products; bio-Merieux, France) and the Phoenyx identification system (Becton Dickinson, USA) were utilised. The

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“…So far, only a few series have characterized the spectrum of encrusted urinary tract infections due to corynebacteria species (Supplementary Table S5). [11][12][13][14][17][18][19][20][21][22][23][24][25][26] Despite suggestive imaging features, diagnosis of encrusted urinary tract infection is challenging given the need for specific culture media to identify corynebacteria species and the important delay between first symptoms and established diagnosis. 27 Of note, most patients present with obstructive renal failure, and most have pre-existing chronic kidney disease at the time of diagnosis, suggesting a chronic unrecognized process.…”

Section: Discussionmentioning

confidence: 99%

“…12 However, cases involving native kidneys were also reported. 13,14 In the present retrospective study, we addressed the spectrum and outcome of patients with encrusted urinary tract infections, focusing more specifically on management and renal outcome.…”

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confidence: 99%

Encrusted Urinary Tract Infections Due to Corynebacteria Species

Sakhi

Join‐Lambert

Goujon

et al. 2021

Kidney International Reports

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Introduction: Encrusted pyelitis and cystitis are peculiar disorders characterized by the calcification of the vesical, the pyelic, and/or the ureteral walls. These calcifications are composed of struvite and calcium carbonate-apatite due to the presence of Corynebacterium urealyticum. Methods:We have identified the clinical features and outcomes of 17 patients with encrusted pyelitis (n ¼ 15) or encrusted cystitis (n ¼ 2). Diagnosis was based on computed tomography scan and sonography including thickening and calcified lesions of the urinary tract.Results: The main clinical presentation was suggestive of subacute urinary tract infection with fever and urologic symptoms, mostly gross hematuria. Biologic features were characterized by the presence of struvite crystals and alkaline urine. Acute kidney injury was reported in 70.6% of cases. Predisposing factors were mostly due to urologic background (82.4%) with a history of urologic procedure (71%) and prior exposure to antibiotics (59%). All patients received appropriate antibiotherapy and 15 were treated with topical urinary acidification. A significant reduction of encrusted calcifications was observed in 88% of cases. Renal function improved in 71% of the patients. Nevertheless, poor tolerance of the treatment and side effects were common, affecting 71% of patients, with Gram-negative bacilli urinary tract infections (53%) being the most frequent. At last follow-up, 4 patients (23.5%) progressed to end-stage renal disease and only 1 had a clinical relapse.Conclusions: Encrusted urinary tract infections are rare, characterized by a severe renal and overall prognosis in the absence of appropriate treatment. Topical urinary acidification and appropriate antibiotherapy are efficient but may be burdened by significant adverse events.

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Encrusted Cystitis and Pyelitis

Cited by 20 publications

References 5 publications

The lifestyle of Corynebacterium urealyticum derived from its complete genome sequence established by pyrosequencing

The lifestyle of Corynebacterium urealyticum derived from its complete genome sequence established by pyrosequencing

Encrusted Cystitis in an Immunocompromised Patient: Possible Coinfection by Corynebacterium Urealyticum and E. Coli

Encrusted Urinary Tract Infections Due to Corynebacteria Species

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